Eighty patients with knee osteoarthritis (OA) were randomized to undergo standard minimally-invasive total knee arthroplasty (TKA) with or without computer assistance, to compare the two techniques with respect to clinical and radiological outcomes. Results at 6 months indicated that computer-assisted minimally-invasive total knee arthroplasty (MICA-TKA) produced similar Knee Society Scores (KSS), Knee Society Functional Scores (KSFS), pain scores, and range of motion, with less blood loss and better radiological alignment, compared to minimally-invasive TKA (MI-TKA). Both procedures were safe, with no incidence of infection, neurovascular complication or revision surgery within this present sample.